Background: One way to target polypharmacy and inappropriate medication in hemodialysis (HD) patients is with medication deprescribing. Objective: To assess the impact of implementing a pharmacist-led deprescribing program on medication adherence among HD patients. Method: A prospective interventional, one-group pretest-posttest-only design study was conducted at a hemodialysis center in Wasit Governorate, Iraq. Medication reconciliation followed by medication review based on the deprescribing program was done for all eligible patients, and the patients were monitored for three months for any possible complications. Results: Two hundred and seventy patients were screened for eligibility. Only one hundred and eighteen were enrolled in the deprescribing program. The median age was 51.5 years, 56.8% were males, and hypertension was the most common etiology for their chronic kidney disease (CKD); 78% had comorbidities. After deprescription, there was a significant reduction in the number of medications from 6.0 to 4.0 and a reduction in the number of pills from 7.0 to 5.0. Medication adherence accessed using the Arabic version of Morisky, Green, and Levine’s (MGL) adherence scale also had a significant reduction from 2.0 to 1.0. Conclusion: A pharmacist-led deprescribing program is a successful strategy for decreasing the number of medications and daily pills prescribed while simultaneously improving hemodialysis patients' adherence to their regimens without compromising the patient’s safety.
This study aims at examining and confirming the patterns of phenetic relationships and the levels of variations within and among the species of Lotus L., 1753 in Egypt by using morphometric analysis techniques. We have evaluated 24 morphological characters from about 300 herbarium specimens representing 19 species of Lotus that are currently recognized. Based on numerical analyses of macromorphological characters (cluster analysis, principal coordinate analysis and principal component analysis), 19 species of Lotus were recognized from Egypt. These species were clustered in six species-specific groups: (I) Lotus halophilus Boiss. & Spruner, L. angustissimus L., L. glinoides Delile and L. schimperi Steud. ex Boiss., (II) Lotus glaber
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After the defeat of the military terrorist organization "ISIS" and the fall of the throne of its alleged state in the Iraqi city of Nineveh, in Syrian Baghouz, and the end of its control over the land, the Syrian camps, especially "Al-Hol" camp, emerge as an incubator for the ideology of the terrorist organization "ISIS" and a vital base for its consolidation and dissemination, which includes (68,000- 73,000) people. During the years following the military defeat of (ISIS), the camp witnesses the spread of extremist ideas widely at the hands of its residents, including the families of the organizations dead's, extremist detainees, and those who deal with it, taking advantage of the deterioration of the environmental, se
... Show MoreABSTRACT This study closely investigates the elements of Sigmund Freud’s theory “The Uncanny” in one of Larson’s most famous novels. Although the novel touches upon racial issues, the study explores the mysterious relationship between Irene and Clare based on the main features of Freud’s “The Uncanny,” which are represented by hidden sexual desire, envy, supernatural power, and double characters. The aspect of the sexual desire is indicated in the novel by sexual undertones expressed by Irene towards Clare’s physical features. Envy in the novel is expressed by Irene who shows resentful longing aroused by Clare’s possessions and qualities due to her passing to the white community. The aspect of omnipotence of thoughts is in
... Show MoreThis work studied the electrical and thermal surface conductivity enhancement of polymethylmethacrylate (PMMA) clouded by double-walled carbon nanotubes (DWCNTs) and multi-walled carbon nanotube (MWCNTs) by using pulsed Nd:YAG laser. Variable input factors are considered as the laser energy (or the relevant power), pulse duration and pulse repetition rate. Results indicated that the DWCNTs increased the PMMA’s surface electrical conductivity from 10-15 S/m to 0.813×103 S/m while the MWCNTs raised it to 0.14×103 S/m. Hence, the DWCNTs achieved an increase of almost 6 times than that for the MWCNTs. Moreover, the former increased the thermal conductivity of the surface by 8 times and the later by 5 times.
A characteristic study of a passively Q-switched diode pumped solid state laser system is presented in this work. For laser a comparison study for the theoretically calculated results with a simulation results using a software which calculates the Q-switched solid state laser parameters was such as energy, peak power and pulse width were performed. There was a good agreement between our theoretical calculations and the simulation values.
The aim of this research work is to evaluate the use of 980 nm diode laser in clotting the blood
in the bone socket after tooth extraction. The objective is to prevent possible clot dislodgement which is
a defect that may lead to possible infection. A number of rabbits were irradiated using 980nm CW mode
diode laser, 0.86W power output for 9s and 15s exposure time. The irradiated groups were studied
histopathologically in comparison with a control group. Results showed that laser photothermal
coagulation was of benefit in minimizing the possibility of the incidence of postoperative complications.
The formation of the clot reduces the possibility of bleeding and infection.
The finite element method has been used in this paper to investigate the behavior of precast reinforced concrete dapped-ends beams (DEBs) numerically. A parametric investigation was performed on an experimental specimen tested by a previous researcher to show the effect of numerous parameters on the strength and behavior of RC dapped-end beams. Reinforcement details and steel arrangement, the influence of concrete compressive strength, the effect of inclined load, and the effect of support settlement on the strength of dapped-ends beams are examples of such parameters. The results revealed that the dapped-end reinforcement arrangement greatly affects the behavior of dapped end beam. The failure load decreases by 25% when
... Show MoreThe present study tackles the complex issue of the urgent need for Environmental Auditing (EA) in Iraq in the absence of laws that support environmental management and in the light of the high rates of cancerous diseases in Iraq, which coincided significantly with the increase in oil production, according to the numbers indicated in the Iraqi Ministry of Health. The study aimed to investigate the mediating role of Management Systems (MS) related to the role of EA supporting sustainability reports concerning the reduction of the negative effects of gas emissions from oil companies. We adopted the descriptive approach which relies on studying relationships through a questionnaire that was distributed to a group of workers at Doura Refinery in
... Show MoreThe influence of an aortic aneurysm on blood flow waveforms is well established, but how to exploit this link for diagnostic purposes still remains challenging. This work uses a combination of experimental and computational modelling to study how aneurysms of various size affect the waveforms. Experimental studies are carried out on fusiform-type aneurysm models, and a comparison of results with those from a one-dimensional fluid–structure interaction model shows close agreement. Further mathematical analysis of these results allows the definition of several indicators that characterize the impact of an aneurysm on waveforms. These indicators are then further studied in a computational model of a systemic blood flow network. This demonstr
... Show MoreThe current study aimed to standardize the multi-position suicidal tendency scale MAST in the Saudi environment as well as to assess suicidal tendencies in adolescents. Moreover, the study aimed to test the psychometric characteristics of the scale among a sample of (490) high school and undergraduate students, in the adolescence who ranging in age from (16-21) years. The scale demonstrated satisfactory internal consistency in terms of validity and reliability tests. as the results showed of exploratory factor analysis to the four dimensions of suicidal tendencies loading on two factors that accommodate 74.60% of the overall variance of the scale (1) the attitude toward life, and absorbs 43, 20% of the total variance of the scale,
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